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RESEARCH

Bond Durability of a Repaired Resin Composite Using a

Universal Adhesive and Different Surface Treatments
Jitrlada Chuenweravanicha / Watcharaporn Kuphasukb / Pipop Saikaewc / Vanthana Sattabanasukc

Purpose: To evaluate the long-term effect of different surface treatments on the repair microtensile bond strength
(μTBS) of resin composite using a universal adhesive.
Materials and Methods: Thirty-six resin composite blocks were fabricated and aged in 37°C distilled water for
1 month. The blocks were randomly assigned to different surface treatments: no treatment (control); diamond bur
grinding (D); diamond bur + phosphoric acid cleaning (DP); diamond bur + silane application (DSi); diamond bur +
phosphoric acid + silane (DPSi); and grit blasting with 50 μm Al2O3 particles + phosphoric acid + silane (APSi).
Thereafter, Single Bond Universal adhesive was applied and repaired with the same composite. Composite-com-
posite stick-shaped specimens were fabricated and subjected to the μTBS test either after 37°C water storage for
24 h or thermocycling for 10,000 cycles. Roughness of different surface-prepared specimens was measured by
profilometer. Data were analysed using ANOVA and Duncan’s post-hoc test (α = 0.05). Failure mode and micromor-
phology of different surface-prepared specimens were observed with SEM and EDS analysis.
Results: The highest μTBS was found in DPSi group at 24 h, and was significantly higher than others. The bond
strengths in all thermocycled groups were significantly lower than those measured at 24 h. The highest μTBS was
also found in the DPSi group, but this did not significantly differ from the DSi group.
Conclusion: Thermocycling significantly reduced the repair bond strength. Diamond bur roughening with application
of silane and universal adhesive yielded the highest repair bond strength for the aged resin composite.
Keywords: bond durability, resin composite repair, surface treatments, universal adhesive.

J Adhes Dent 2022; 24: 67–76. Submitted for publication: 10.06.21; accepted for publication: 23.08.21
doi: 10.3290/j.jad.b2288293

toration.35 When composite restorations fail as a result of

R esin-based composites represent the most widely used
direct restorative materials in dental practice, due to
their esthetic and adhesive characteristics along with the
superior ability to preserve sound tooth structures.19,33,35
However, conditions in the oral environment, such as vary-
ing temperature, pH changes, diet, and other factors, may
cause resin composite to degrade,1 and lead to discolor-
ation, microleakage, wear, chipping, and fracture of the res-
a Dentist, Operative Residency Training Program, Department of Operative Den-
tistry and Endodontics, Faculty of Dentistry, Mahidol University, Bangkok,
Thailand. Performed the experiments, wrote the manuscript.
b Assistant Professor, Department of Operative Dentistry and Endodontics, Fac-
ulty of Dentistry, Mahidol University, Bangkok, Thailand. Idea, experimental
design, proofread the manuscript.
c Assistant Professor, Department of Operative Dentistry and Endodontics, Fac-
ulty of Dentistry, Mahidol University, Bangkok, Thailand. Idea, experimental
design, proofread the manuscript.
Correspondence: Assistant Professor Watcharaporn Kuphasuk, Department of
Operative Dentistry and Endodontics, Faculty of Dentistry, Mahidol University,
6 Yothi Road, Ratchathewi District, Bangkok 10400, Thailand.
Tel: +66-2-200-7825; e-mail: watcharaporn.kup@mahidol.ac.th
secondary caries, fracture of tooth or restorations, or dis-
coloration of the restorations, they need to be repaired or
replaced. In cases where the replacement is an option, sig-
nificant loss of sound tooth structures usually occurs.13 As
a result, it increases the risk of more complex and more
costly subsequent treatment. For this reason, restoration
repair is considered a minimal-intervention approach, and it
also increases restoration longevity. The additional advan-
tages of restoration repair are cost reduction, preservation
of tooth structures, and less chair time.18
Studies on composite repair reported considerable diffi-
culty in establishing a durable bond between the already
polymerized and freshly repaired material. The resin com-
posite of existing restorations may be deteriorated by me-
chanical, thermal, and chemical stresses in the intra-oral
environment.27 In this regard, thermocycling and water stor-
age of bonded specimens are well-accepted methods to
simulate aging and stress interfacial bonds.29 Furthermore,
accelerated water diffusion between bonded materials may
weaken the adhesive interface.30 It would, therefore, be of
interest to evaluate the behavior of different coupling mater-
ials that are applied for composite repair under aging condi-
tions. Additionally, the success of the composite repair pro-

Vol 24, No 1, 2022 67

Chuenweravanich et al
Table 1 Composition and instructions for use of materials used in the study
Materials Manufacturer Batch No.
Single 3M Oral Care 80411A
Bond Universal (St Paul, MN,
USA)
Porcelain primer Bisco 1900000408
(Schaumburg,
IL, USA)
Ultra-etch Ultradent (South BCV2C
Jordan, UT, USA)
Filtek Z350 XT 3M Oral Care 7018A1B,
(A1, A4 body 7018A4B
shade)
HEMA: 2-hydroxyethyl methacrylate; 10-MDP: 10-methacryloyloxydecyl dihydrogen phosphate; bis-GMA: bisphenol glycidyl methacrylate; UDMA: urethane
dimethacrylate; bis-EMA: bisphenol A ethoxylated dimethacrylate; PEG-DMA: polyethylene glycol dimethacrylate; TEG-DMA: triethylene glycol dimethacrylate.
cedures relies on several factors, such as the surface
characteristics, wettability of the chemical bonding agents,
and chemical composition of the composites.15,21,23
Surface roughness is crucial for composite repair and
can be achieved mechanically using several techniques, eg,
grit blasting with aluminum oxide particles,2,4,6,7,15,36 etch-
ing with hydrofluoric acid,4,14,15 and roughening with dia-
mond burs.2,6,7,15,24 In addition to micromechanical reten-
tion, chemical bonding is also a desirable method to
increase the bond strength of repaired composite.4 Silane
coupling agents chemically bond the fillers of the old resin
composite to the organic resin matrix of the new one.16,17
Therefore, the application of a silane coupling agent is rec-
ommended for resin composite repair.31
Dental adhesives also play an important role in the re-
pair-composite bond strength by increasing the wettability
of the pre-treated, silanized surface.5 Recently, a new gen-
eration of adhesives called “multi-mode” or “universal” ad-
hesives has been introduced. Most of them contain acidic
functional monomer, 10-methacryloyloxydecyl dihydrogen
phosphate (10-MDP), and silane. Consequently, this would
enable bonding to various substrates without the need for
a separate primer, ie, a silane coupling agent. Considering
that cavity surfaces for composite repair may include vari-
ous substrates, eg, dentin, enamel, and composite, a uni-
versal adhesive may be more user friendly and less time
consuming for repair procedures.
At present, there is limited information on different repair
systems with various conditioning protocols using the uni-
versal adhesive. Therefore, the aim of this study was to
evaluate the long-term effects of different surface treat-
ments on the repair bond strength of resin composite using
a universal adhesive. The tested null hypotheses are that
surface treatments and artificial aging by thermocycling do
not have an effect on the repair bond strength.
68
Main components Instructions for use
10-MDP phosphate monomer, Apply adhesive to the treated surface
dimethacrylate resins, bis-GMA, HEMA, with rubbing action for 20 s and then
methacrylate-modified polyalkenoic acid direct a gentle stream of air to the
copolymer, camphorquinone, filler, surface for 5 s, light cure for 10 s.
ethanol, water, initiators, silane (pH 2.7)
1%-5% silane, 30%-50% alcohol, 30%- Apply one thin coat of porcelain
50% acetone (pH 5.9) primer to the surface and allow to
react for 30 s, air dry.
35 wt% phosphoric acid, 60% water, 5% Apply to the treated surface for 30 s,
synthetic amorphous silica as and subsequently wash with air-water
thickening agent spray for 30 s, air dry for 10 s.
Silane-treated ceramic, silane-treated Apply a layer of 2 mm, light cure for
silica, silane-treated zirconia, UDMA, 20 s each layer.
bis-EMA, bis-GMA, PEG-DMA, TEG-DMA
MATERIALS AND METHODS
The restorative materials used in the present study, along
with their classification, manufacturers, batch numbers,
compositions, and directions for use, are presented in
Table 1. A total of 36 resin composite blocks were built
using the A1 body shade of a nanofilled resin-based com-
posite (Filtek Z350XT, 3M Oral Care; St Paul, MN, USA).
The specimens were fabricated using a silicone mold with
dimensions of 4 mm x 8 mm x 4 mm. The composite was
placed into the mold in two 2-mm increments. Each incre-
ment was light cured for 20 s using an LED light-curing unit
(Bluephase, Ivoclar Vivadent; Schaan, Liechtenstein) with a
light intensity of 1200 mW/cm2 as measured by a radiom-
eter (Bluephase meter; Ivoclar Vivadent). Prior to photopoly-
merizing the second increment, a glass microscope slide
was used to cover and compress the composite to obtain a
flat surface. After that, the resin composite blocks were
removed from the mold. Each block was additionally cured
from the top surface for 20 s. The top surface (4 x 8 mm2)
was then polished with 600-grit SiC abrasive paper under
water cooling for 15 s,15 to obtain a homogenous surface.
Subsequently, the blocks were ultrasonically cleaned for
5 min and stored in distilled water at 37°C for 30 days in
an incubator to simulate the aging process.9 Aged speci-
mens were randomly allocated to 6 experimental groups
(n = 6) according to the repair bonding procedures.
Six blocks of each group were subjected to one of 6 differ-
ent surface treatments: group C (control): no further treat-
ment was performed on the composite surface; group D:
roughening with an extra-fine diamond bur (#837 KREF 314
014, ISO 806 314 158 504 014, Komet; Lemgo, Germany)
mounted in a high-speed handpiece at 200,000 rpm, parallel
to the surface, then cleaned with air-water spray for 30 s,
and air dried for 10 s; group DP: roughening with diamond
The Journal of Adhesive Dentistry

New
composite
Surface
treatments
Aged composite
Fig 1 Schematic procedure of the specimen preparation and microtensile bond strength test set-up.
bur as previously described, plus phosphoric acid cleaning;
group DSi: roughening with diamond bur and silane applica-
tion; group DPSi: roughening with diamond bur, phosphoric
acid cleaning, then silane application; group APSi: the sur-
face was grit-blasted with 50-μm aluminum oxide powder for
10 s at a working distance of 10 mm under a pressure of
40 psi using an intra-oral grit blaster (KCP-1000 Whisper Jet,
American Dental Airsonic Technologies; Corpus Christi, TX,
USA), then cleaned with air-water spray for 30 s, air dried for
10 s, cleaned with phosphoric acid, followed by silane appli-
cation. The uses of phosphoric acid gel and silane coupling
agent strictly followed the instructions as noted in Table 1.
After the surface treatments, Single Bond Universal Ad-
hesive (3M Oral Care) was applied to the specimens using
a rubbing action for 20 s. Specimens were then gently air
blown for 5 s to evaporate the solvent and spread the adhe-
sive into a thin film. This was then light cured for 10 s ac-
cording to the manufacturer’s instructions.
Repair Procedures
A silicone mold of 4 mm x 8 mm x 8 mm was used. After
the respective surface treatments and bonding procedures,
each specimen was inserted into the mold, leaving a 4-mm
space to be filled by the fresh composite. Care was taken
not to contaminate the prepared surface. The A4 body
shade of the nanofilled resin-based composite (Filtek
Z350XT; 3M Oral Care) was incrementally inserted and light
cured in the same manner as described above. All speci-
mens were removed from the mold, and then stored in dis-
tilled water for 24 h at 37°C in the incubator prior to micro-
tensile bond strength testing.
Specimen Preparation for Bond Strength Testing
The repaired composite blocks were sectioned perpendicu-
lar to the bonding interface using a slow-speed diamond
Vol 24, No 1, 2022
Chuenweravanich et al
1 mm
8 mm
4 mm
4 mm
4 mm
8 mm
blade under water cooling in a sectioning machine (IsoMet
1000, Buehler; Lake Bluff, IL, USA). Ten central specimens
were obtained from each block, with a bonding area of ap-
proximately 1 x 1 mm2 (Fig 1). Five stick specimens were
randomly selected for 24-h storage in distilled water at
37°C. The remaining five specimens were allocated to ther-
mocycling (5°C-55°C, dwell time 30 s, transfer time 4 s)22
for 10,000 cycles (TC 301, Medical and Environmental
Equipment Research Laboratory; Bangkok, Thailand).
Microtensile Bond Strength(μTBS) Test
The cross-sectional area of each specimen was measured
by a digital caliper (Mitutoyo; Tokyo, Japan). Then, each
bonded stick was attached to a jig in a universal testing
machine (LF plus, Lloyd Instruments; Bognor Regis, UK)
using a cyanoacrylate adhesive (Model Repair II Blue,
Dentsply-Sankin; Otawara, Japan). Each specimen was
loaded in tension until fracture at a crosshead speed of
1 mm/min. The force at failure was utilized to calculate the
microtensile bond strength using the following equation:
m = F/A, where m = μTBS (MPa), F = load at failure (N), and
A = area at the bonded interface (mm2). The mean bond
strength obtained from each block was used for data
analysis. Pre-test failures, if any, were recorded as 0 MPa
and were included in the calculation.
Failure Mode Analysis
After the microtensile bond strength test, the fractured
specimens were positioned on an aluminum stub with a
carbon double-sided tape, then coated with a palladium
conductive layer via sputtering (SC7620 Mini Sputter
Coater; Quorum Technologies; Lewes, UK). The specimens
were examined with SEM (JSM-6610LV, JEOL; Tokyo,
Japan) at 80X magnification. Failure modes were classified
as follows:20
69
Chuenweravanich et al

Table 2 Two-way ANOVA for microtensile bond strength

Source df F p-value Observed power

Corrected Model 11 76.913 0.000 1.000
Intercept 1 12774.311 0.000 1.000
Surface treatment 5 104.210 0.000 1.000
Aging 1 299.396 0.000 1.000
Surface treatment x aging 5 5.118 0.001 0.978
Error 60
Total 72
Corrected total 71

Fig 2 Means and stan-

70 dard deviations of μTBS in
Microtensile bond strength (MPa)

a
b
b b MPa of the resin composite
60 with different repair proto-
c c
c cols after 24 h and 10,000
50
cycles of thermocycling.
d d
40 e
Mean values with the same
e superscript letters are not
30 f statistically different (two-
way ANOVA and Duncan’s
20 multiple comparison test,
p > 0.05).
10

0
C D DP DSi DPSi APSi
24 h 10,000 TC

100%
Fig 3 Failure analysis of
the specimens using differ-
90% ent surface treatments,
80% and with or without artificial
aging. TC: thermocycling.
70%

60%

50%

40%

30%

20%

10%

0%
Control 24 h Control TC D 24 h D TC DP 24 h DP TC DSi 24 h DSi TC DPSi 24 h DPSi TC APSi 24 h APSi TC

Adhesive failure Cohesive failure Mixed failure

y Type I: adhesive failure – fractured area involved at least Micromorphological Observation and Energy
75% of the interface between resin composite and ad- Dispersive X-ray Spectroscopy of Prepared Surfaces
hesive. Eighteen slices (4 mm x 6 mm x 2 mm) of the nanofilled
y Type II: cohesive failure – fractured area involved at least resin-based composite (Filtek Z350XT; 3M Oral Care) were
75% within the resin composite or adhesive. examined for each group (n = 3). The specimens were pre-
y Type III: mixed failure – fractured area involved both ad- pared and surfaces polished with 600-grit SiC abrasive
hesive failure and cohesive failure in resin composite or paper under running water for 15 s, and then ultrasonically
adhesive, each less than 75%. cleaned in distilled water for 5 min. The slices were as-

70 The Journal of Adhesive Dentistry


Fig 4 Representative SEM images of
the debonded surfaces of resin composite a b
sticks using different repair protocols.
Cohesive failure in the diamond bur and
grit blasting groups (a and b, respectively).
Adhesive failure in the diamond bur and grit
blasting groups (c and d, respectively).
Mixed failure in the diamond bur and grit
blasting groups (e and f, respectively).
c d
e f
signed to 6 different surface treatments: 1. the control; 2.
diamond bur roughening with and 3. without phosphoric
acid cleaning; 4. grit blasting with and 5. without phos-
phoric acid cleaning; and 6. grit blasting with ultrasonic
cleaning. After that, the specimens were coated with palla-
dium, and the surface morphology was observed using SEM
at 1000X, 2000X, and 3000X magnifications.
Energy dispersive x-ray spectroscopy (EDS X-Max; Oxford
Instruments; Bristol, UK) was used to determine the elemen-
tal compositions of the prepared composite surfaces. The
amounts of C, O, Si, and Al were measured at 500X magnifi-
cation. Data were obtained using an SEM (JSM-6610LV;
JEOL) with an attached EDS x-ray detector.
Surface Roughness Measurement
Additional 25 slices (4 mm x 3 mm x 2 mm) of the nanofilled
resin-based composite (Filtek Z350XT; 3M Oral Care) were
prepared and divided into five subgroups according to sur-
Vol 24, No 1, 2022
Chuenweravanich et al
face treatments (n = 5): 1. control; 2. diamond bur roughen-
ing with and 3. without phosphoric acid cleaning; 4. Grit
blasting with phosphoric acid cleaning; 5. grit blasting with
ultrasonic cleaning. Surface roughness (Ra in μm) was mea-
sured on each specimen using a surface profilometer (Taly-
surf Series 2, Taylor Hobson; Leicester, UK) with five succes-
sive measurements in different directions for all specimens.
The mean value was calculated for each subgroup.
Statistical Analysis
The microtensile bond strength and surface roughness data
were analyzed for normal distribution using the Kolmogorov-
Smirnov test. Two-way ANOVA was performed on the micro-
tensile bond strengths, while one-way ANOVA was calculated
for the surface roughness. Duncan’s test was performed to
detect statistical differences between the variables and
compare the groups. All tests were performed at a 5% sig-
nificance level using SPSS v 20.0 (IBM; Armonk, NY, USA).
71
Chuenweravanich et al
a b
c d
e f
RESULTS
Microtensile Bond Strength and Failure Mode
Analysis
Pre-test failures were observed in the thermocycling group of
the control, D, DP, and DSi. Two-way ANOVA (Table 2) re-
vealed significant effects of surface treatment (F = 104.21,
p < 0.001) and aging (F = 299.39, p < 0.001) on the bond
strength. The interaction between the two variables was
also significant (F = 5.11, p = 0.001). Means and standard
deviations of the microtensile bond strengths are shown in
Fig 2. In the 24-h group, all surface treatments provided
significantly higher bond strengths than the control. The DSi
and DPSi groups resulted in significantly higher bond
strengths than the D and DP groups, respectively. The DP
group revealed higher bond strength than the D group.
Moreover, the DPSi group revealed higher bond strength
than the DSi group. The APSi group had significantly lower
bond strength than the DPSi group, but was not significantly
different from the DSi or DP groups. After thermocyling, the
lowest bond strength was also found in the control group.
The bond strengths of all thermocycling groups were signifi-
72
Fig 5 Representative SEM images of the
prepared surfaces with different surface
treatments observed at 3000X magnifica-
tion. a. Composite surface in the control
group. Minor topographical changes due to
scratches from 600-grit SiC paper were
detected. Note that the fillers were lost
from the composite surface. b. Composite
surface after grinding with a diamond bur,
followed by water spray cleaning. Scratches
and grooves covered with streaks of smear
matrix were observed. Notice also the
dislodgement of filler cluster (red arrow).
c. Composite surface after grinding with a
diamond bur, and phosphoric acid cleaning.
The texture was similar to (b) with a clean
surface. d. Composite surface after grit
blasting with 50-μm Al2O3 particles.
A roughened, highly irregular topography
was produced, with numerous microretentive
fissures. Note that the surface was covered
with abundant grit-blasting particles (blue
arrows). e. Composite surface after grit
blasting with 50-μm Al2O3 particles,
followed by phosphoric acid cleaning.
The surface texture was similar to (d),
but was less covered with grit-blasting
particles. f. Composite surface after grit
blasting with 50-μm Al2O3 particles,
followed by ultrasonic cleaning group.
The surface texture was similar to (d)
with less coverage of grit-blasting particles.
cantly lower than those measured at 24 h. The highest
bond strength was found in the DPSi group; however, it was
not significantly different when compared to the DSi group.
The failure mode distribution of the specimens is shown
in Fig 3. For 24-h storage, the APSi group showed 70% co-
hesive failure. In the diamond bur groups (D, DP, DSi,
DPSi), the highest cohesive failure rate (70%) was found in
the DSi group, while the others revealed a range between
36% and 50%. After thermocycling, the APSi, D, DSi, and
DPSi groups showed similar percentages of cohesive fail-
ure, approximately 50%, except in the DP group. Represen-
tative SEM images of the fractured specimens are pre-
sented in Fig 4.
Micromorphological Observation of the Prepared
Surfaces with SEM
SEM observation of the treated composite substrates reveal-
ing different surface textures are shown in Fig 5. Minor topo-
graphical changes due to scratches from abrasion of 600-grit
SiC paper were detected, and the fillers were dislodged from
the composite surface (Fig 5a). Scratches and grooves cov-
ered with streaks of smear matrix, as well as the dislodge-
The Journal of Adhesive Dentistry
 Chuenweravanich et al

a b c d e f

Fig 6 SEM images (top) and EDS mapping of the elemental distributions on the prepared composite surfaces. a. Grinding with 600-grit SiC
paper; b. diamond bur roughening; c. diamond bur roughening followed by phosphoric acid cleaning; d. grit blasting; e. grit blasting followed by
phosphoric acid cleaning; f. grit blasting followed by ultrasonic cleaning. C: carbon; O: oxygen; Si: silicon; Al: aluminum.

ment of fillers, can be observed on the composite substrate
after roughening with an extra-fine diamond bur (Fig 5b).
However, etching with phosphoric acid did not cause any
morphological changes in the retentive pattern of the simi-
larly treated composite, apart from producing a clean surface
(Fig 5c). Grit blasting with 50-μm Al2O3 particles produced a
rough, highly irregular surface topography, creating numerous
microretentive fissures (Fig 5d). Etching with phosphoric acid
here also did not cause any morphological changes in the
retentive pattern of the similarly treated composite surface,
apart from producing a cleaning effect (Fig 5e). Grit blasting
with 50-μm Al2O3 particles followed by ultrasonic cleaning
produced similar surface texture to Fig 5d, but the surface
was less covered with Al2O3 particles (Fig 5f).
grit-blasted and phosphoric-acid cleaned, and grit-blasted
and ultrasonically cleaned groups, respectively. SEM im-
ages and EDS analysis presenting the elemental mapping
of C, O, Si, and Al on the prepared composite surfaces are
shown in Fig 6. Elemental compositions of the differently
prepared surfaces are shown in Table 3.
Surface Roughness Measurement
One-way ANOVA revealed a significant difference in surface
roughness between all surface treatment groups and the
control group. However, no significant difference was found
among the surface treatment groups. Means and standard
deviations of surface roughness measurement are shown in
Table 4.

EDS Analysis
From the SEM images of the prepared composite surfaces
subjected to different surface treatments, remnants of alu-
minum abrasive particles were still observed on the grit-
blasted surface after phosphoric acid cleaning, and even
after ultrasonication. The amount of aluminum was found to
be 1.50 wt%, 0.25 wt%, and 0.16 wt% for the grit-blasted,
DISCUSSION
This study evaluated the effects of micromechanical and
chemical surface treatments on the repair bond strength of
a resin composite. Surface treatment with grit blasting fol-
lowed by silane application was selected as the recom-

Vol 24, No 1, 2022 73

Chuenweravanich et al
Table 3 Elemental compositions of the prepared surfaces with different treatments
Surface treatment C (Carbon)
Control
Diamond bur
Diamond bur with H3PO4 cleaning
Grit blasting
Grit blasting with H3PO4 cleaning
Grit blasting with ultrasonic cleaning
Table 4 Mean surface roughness (Ra in μm) values and
standard deviations according to different treatments
Ra in μm
Surface treatments (mean ± S.D.)
Control 0.42 ± 0.06b
Diamond bur 1.02 ± 0.06a
Diamond bur with H3PO4 cleaning 0.97 ± 0.09a
Grit blasting with H3PO4 cleaning 1.05 ± 0.17a
Grit blasting with ultrasonic cleaning 1.08 ± 0.12a
Mean values with the same superscript letters are not statistically significantly
different (one-way ANOVA and Duncan’s multiple comparison, p > 0.05).
mended protocol for composite repair.2,14 Surface rough-
ness was measured to evaluate the effect of mechanical
surface treatments, whereas EDS was performed for chem-
ical analysis. The long-term bond strength was evaluated
after artificial aging with 10,000 cycles of thermocycling.
According to the results of this study, surface treatment
and the artificial aging demonstrated significant effects on
the repair bond strength of a resin composite using a uni-
versal adhesive (p ≤ 0.001). Therefore, both null hypothe-
ses were rejected.
The repair bond strength of resin composite depends on
two main mechanisms: the micromechanical bond and the
chemical bond.7,11 The effect of the micromechanical bond
is illustrated by the repair bond strengths of the D and DP
groups, which were significantly higher than that of the con-
trol group. In our study, the resin composite blocks in the
control group were only ground with 600-grit SiC paper in
order to standardize the repaired surface. It has been re-
ported that the surface roughness created by diamond bur
was significantly higher than that produced by SiC paper,
resulting in increased surface area for bonding.26 This is in
agreement with surface roughness measurements
(Table 4), as the Ra of the D and DP groups were signifi-
74
Element (weight%)
O (Oxygen) Si (Silicon) Al (Aluminum)
25.00 38.64 23.13 N/A
23.32 40.10 23.30 N/A
23.37 40.49 22.88 N/A
24.77 38.48 22.85 1.50
28.63 34.45 23.76 0.25
27.85 37.66 22.34 0.16
cantly higher than that of the control group. In addition, the
macro- and microretentive features created by diamond bur
roughening could also lead to better surface wetting.4,9,34
The chemical bond also plays an important role in repair
procedures.2,3,25,32 Silane treatment during repair proced-
ures promotes chemical bonding by forming siloxane bonds
between silica-containing filler particles exposed on the re-
pair surface and the resin matrix of the fresh resin
layer.12,17 According to the results of this study, the repair
bond strengths of the DSi and DPSi groups were higher than
those of the D and DP groups, respectively (Fig 2). The sig-
nificant improvement of the repair bond strengths could be
the result of the separate silane application.2,3,9,31,32 The
chemical effect of silane is also supported by the failure
analysis, as a lower incidence of adhesive failures was ob-
served in the groups in which silane was applied (Fig 3). In
addition, the benefit of a separate silane primer is in accor-
dance with Yoshihara et al,37 who demonstrated that the
silane incorporated in Single Bond Universal adhesive was
not as effective as a separate silane primer in repair proced-
ures. The incorporated silane was no longer stable, most
likely because the low pH of Single Bond Universal pro-
motes hydrolysis and dehydration condensation of silanol.
With phosphoric acid application, the repair bond
strengths of the DP and DPSi groups were significantly
higher than those of the D and DSi groups, respectively.
SEM images (Figs 5c and 5e) showed that the use of phos-
phoric acid did not produce any significant micromorpho-
logical changes in the retentive pattern of the composite
surface, and its action was limited to superficial clean-
ing.9,23 As a result, the surface roughness parameters were
similar (Table 4). Nevertheless, etching with phosphoric
acid might also promote the reactivity between a silica sur-
face and a silane coupling agent, and therefore increase
the number of Si–OH units on the silica surface.15
Among the different repair protocols, the DPSi group
demonstrated the highest repair bond strength. Although
the surface roughness values produced by diamond bur
and grit blasting were similar, the repair bond strength of
the DPSi group was significantly higher than that of the
APSi group. The remnants of aluminum on specimens pre-
The Journal of Adhesive Dentistry

pared with grit blasting followed by phosphoric acid clean-
ing were clearly visible in SEM images (Fig 5e) and EDS
analyses (Fig 6e). Grit blasting offers a new, clean surface
which has a high affinity for bonding. Nevertheless, the re-
maining loosely bound, blasted aluminum particles might
act as surface contaminants that can reduce surface wet-
ting and disrupt the interfacial bonds,8 and hence need to
be thoroughly removed. It should be noted that the alumi-
num was still detectable even after ultrasonic cleaning.
Surface treatment using a grit-blasting system in this study
might have provided limited mechanical interlocking.2 The
repair bond strength, therefore, was not as great as that of
the DPSi group. Other studies, however, used a grit-blast-
ing system with tribochemical silica coating, and reported
improved bond strength.15,25 The tribochemical reaction
produces a high-temperature contact area that can hold
the blasted particles and/or the silica layer on the surface.
Surface roughening with silica-modified alumina particles
and the chemical bonds between silica-enriched surface
and resin materials could enhance the repair bond
strength, compared with the sole use of grit blasting. Fur-
ther study is required to confirm this speculation and to
find the best method to clean grit-blasted surfaces for
intra-oral repair.
Interestingly, the results of the current study show that
surface preparation with a diamond bur combined with sep-
arate silane application provided higher repair bond
strength than using grit blasting with silane. This method
could be advantageous for clinicians, as the repair proced-
ure is less complicated without the use of an intra-oral grit
blaster. Moreover, diamond bur roughening is simple, cost
effective, and does not require additional instruments.
Repaired resin composite was artificially aged using
thermocycling. It has been reported that thermocycling re-
sulted in the lowest repair bond strength compared to a
citric acid challenge for 1 week, or boiling in water for
8 h.21 In addition, it has also been suggested that 10,000
cycles of thermocycling represented the effect of one year
of clinical aging.10 Therefore, 10,000 thermocycles were
performed in this study. The bonded composite blocks
were cut into composite-composite sticks before being sub-
jected to thermocycling in order to accelerate the aging
process.28 The repaired specimens were exposed to tem-
perature changes to produce adverse consequences as a
result of thermal stress and water sorption at the bonded
interface. In this study, the bond strengths in all thermocy-
cling groups were significantly lower than those of 24 h,
which is in accordance with a previous study.22 The effects
of different repair protocols in the thermocycling group
were similar to those observed at 24 h of water storage,
except for the DPSi group. After thermocycling, the highest
repair bond strengths were observed in the DPSi and DSi
groups (Fig 2). However, the DSi group could be more fea-
sible with no additional steps of phosphoric acid etching,
water rinsing, or drying. Therefore, surface roughening with
diamond bur, followed by silanization and application of a
universal adhesive could be a minimal approach for suc-
cessful composite repair.
Vol 24, No 1, 2022
Chuenweravanich et al
CONCLUSION
Diamond bur roughening without phosphoric acid cleaning,
followed by silane application, and the use of a universal
adhesive provided the highest repair bond strength in the
long run.
ACKNOWLEDGMENTS
This work was supported by Educational Program for Operative Den-
tistry Residents.
REFERENCES
1. Akova T, Ozkomur A, Uysal H. Effect of food-simulating liquids on the me-
chanical properties of provisional restorative materials. Dent Mater
2006;22:1130–1134.
2. Bonstein T, Garlapo D, Donarummo J Jr, Bush PJ. Evaluation of varied repair
protocols applied to aged composite resin. J Adhes Dent 2005;7:41–49.
3. Brendeke J, Ozcan M. Effect of physicochemical aging conditions on the
composite-composite repair bond strength. J Adhes Dent 2007;9:399–406.
4. Brosh T, Pilo R, Bichacho N, Blutstein R. Effect of combinations of sur-
face treatments and bonding agents on the bond strength of repaired
composites. J Prosthet Dent 1997;77:122–126.
5. Burtscher P. Stability of radicals in cured composite materials. Dent
Mater 1993;9:218–221.
6. Cavalcanti AN, De Lima AF, Peris AR, Mitsui FH, Marchi GM. Effect of sur-
face treatments and bonding agents on the bond strength of repaired
composites. J Esthet Restor Dent 2007;19:90–98; discussion 99.
7. da Costa TR, Serrano AM, Atman AP, Loguercio AD, Reis A. Durability of
composite repair using different surface treatments. J Dent 2012;40:
513–521.
8. Davis GD. Contamination of surfaces: origin, detection and effect on ad-
hesion. Surf Interface Anal 1993;20:368–372.
9. Fawzy AS, El-Askary FS, Amer MA. Effect of surface treatments on the
tensile bond strength of repaired water-aged anterior restorative micro-
fine hybrid resin composite. J Dent 2008;36:969–976.
10. Gale MS, Darvell BW. Thermal cycling procedures for laboratory testing of
dental restorations. J Dent 1999;27:89–99.
11. Hickel R, Brushaver K, Ilie N. Repair of restorations – criteria for decision
making and clinical recommendations. Dent Mater 2013;29:28–50.
12. Hisamatsu N, Atsuta M, Matsumura H. Effect of silane primers and un-
filled resin bonding agents on repair bond strength of a prosthodontic mi-
crofilled composite. J Oral Rehabil 2002;29:644–648.
13. Krejci I, Lieber CM, Lutz F. Time required to remove totally bonded tooth-
colored posterior restorations and related tooth substance loss. Dent
Mater 1995;11:34–40.
14. Loomans BA, Cardoso MV, Opdam NJ, Roeters FJ, De Munck J, Huys-
mans MC, Van Meerbeek B. Surface roughness of etched composite
resin in light of composite repair. J Dent 2011;39:499–505.
15. Loomans BA, Cardoso MV, Roeters FJ, Opdam NJ, De Munck J, Huys-
mans MC, Van Meerbeek B. Is there one optimal repair technique for all
composites? Dent Mater 2011;27:701–709.
16. Lung CY, Matinlinna JP. Aspects of silane coupling agents and surface
conditioning in dentistry: an overview. Dent Mater 2012;28:467–477.
17. Matinlinna JP, Lassila LV, Ozcan M, Yli-Urpo A, Vallittu PK. An introduction
to silanes and their clinical applications in dentistry. Int J Prosthodont
2004;17:155–164.
18. Mjör IA. Repair versus replacement of failed restorations. Int Dent J
1993;43:466–472.
19. Murdoch-Kinch CA, McLean ME. Minimally invasive dentistry. J Am Dent
Assoc 2003;134:87–95.
20. Niyomsujarit N, Senawongse P, Harnirattisai C. Bond strength of self-
etching adhesives to dentin surface after smear layer removal with ultra-
sonic brushing. Dent Mater J 2019;38:287–294.
21. Ozcan M, Barbosa SH, Melo RM, Galhano GA, Bottino MA. Effect of sur-
face conditioning methods on the microtensile bond strength of resin
composite to composite after aging conditions. Dent Mater 2007;23:
1276–1282.
75
Chuenweravanich et al
22. Ozel Bektas O, Eren D, Herguner Siso S, Akin GE. Effect of thermocycling
on the bond strength of composite resin to bur and laser treated com-
posite resin. Lasers Med Sci 2012;27:723–728.
23. Papacchini F, Dall’Oca S, Chieffi N, Goracci C, Sadek FT, Suh BI, Tay FR,
Ferrari M. Composite-to-composite microtensile bond strength in the re-
pair of a microfilled hybrid resin: effect of surface treatment and oxygen
inhibition. J Adhes Dent 2007;9:25–31.
24. Rathke A, Tymina Y, Haller B. Effect of different surface treatments on the
composite-composite repair bond strength. Clin Oral Investig 2009; 13:
317–323.
25. Ritter AV, Sulaiman T, Altitinchi A, Baratto-Filho F, Gonzaga CC, Correr GM.
Effect of tribochemical coating on composite repair strength. Oper Dent
2020;45:E334–E342.
26. Saikaew P, Senawongse P, Chowdhury AA, Sano H, Harnirattisai C. Effect
of smear layer and surface roughness on resin-dentin bond strength of
self-etching adhesives. Dent Mater J 2018;37:973–980.
27. Sarkar NK. Internal corrosion in dental composite wear. J Biomed Mater
Res 2000;53:371–380.
28. Shono Y, Terashita M, Shimada J, Kozono Y, Carvalho RM, Russell CM,
Pashley DH. Durability of resin-dentin bonds. J Adhes Dent 1999;1:211–218.
29. Sideridou I, Achilias DS, Kyrikou E. Thermal expansion characteristics of
light-cured dental resins and resin composites. Biomaterials 2004;25:
3087–3097.
30. Soderholm KJ, Zigan M, Ragan M, Fischlschweiger W, Bergman M. Hydro-
lytic degradation of dental composites. J Dent Res 1984;63:1248–1254.
31. Staxrud F, Dahl JE. Silanising agents promote resin-composite repair. Int
Dent J 2015;65:311–315.
76
32. Swift EJ Jr, Cloe BC, Boyer DB. Effect of a silane coupling agent on com-
posite repair strengths. Am J Dent 1994;7:200–202.
33. Tyas MJ, Anusavice KJ, Frencken JE, Mount GJ. Minimal intervention den-
tistry--a review. FDI Commission Project 1-97. Int Dent J 2000;50:1–12.
34. Valente LL, Silva MF, Fonseca AS, Munchow EA, Isolan CP, Moraes RR.
Effect of diamond bur grit size on composite repair. J Adhes Dent 2015;
17:257–263.
35. White JM, Eakle WS. Rationale and treatment approach in minimally inva-
sive dentistry. J Am Dent Assoc 2000;131(suppl):13S–19S.
36. Yesilyurt C, Kusgoz A, Bayram M, Ulker M. Initial repair bond strength of
a nano-filled hybrid resin: effect of surface treatments and bonding
agents. J Esthet Restor Dent 2009;21:251–260.
37. Yoshihara K, Nagaoka N, Sonoda A, Maruo Y, Makita Y, Okihara T, Irie
M, Yoshida Y, Van Meerbeek B. Effectiveness and stability of silane cou-
pling agent incorporated in ‘universal’ adhesives. Dent Mater 2016;32:
1218–1225.
Clinical relevance: Surface roughening of repaired resin
composite with the use of diamond bur followed by a
universal adhesive with prior separate silane application
is recommended to improve the repair bond strength in
the long term.
The Journal of Adhesive Dentistry